Exploring snakebite epidemiology between 2010 and 2021 in Paraná, Brazil: introducing distribution patterns, clinical profiles, and sociodemographic factors

To analyze the temporal trend of tuberculosis incidence and mortality rates in Brazil between 2011 and 2019. This was an ecological time series study of tuberculosis incidence and mortality rates in Brazil between 2011 and 2019. Data were extracted from the Notifiable Disease Information System and the Mortality Information System, and population estimates were from the Brazilian Institute of Geography and Statistics. Trends were analyzed by Joinpoint regression, which recognizes inflection points for temporal analysis. The average incidence rate of tuberculosis in Brazil in the period was 35.8 cases per 100 000 population. From 2011 to 2015, this coefficient had an annual percentage change of -1.9% (95% CI [-3.4, -0.5]) followed by an increase of 2.4% (95% CI [0.9, 3.9]) until 2019. The average mortality rate between 2011 and 2019 was 2.2 deaths per 100 000 population, with an average annual percentage change of -0.4% (95% CI [-1.0, 0.2]). Amazonas was the only state with an increase in the annual average percentage variation for the incidence rate (3.2%; 95% CI [1.3, 5.1]) and mortality rate (2.7%; 95% CI [1.0, 4.4]) over the years, while Rio de Janeiro state had an increasing inflection for incidence from 2014 to 2019 (2.4%; 95% CI [1.4, 3.5]) and annual average of decreasing percentage variation (-3.5%; 95% CI [-5.0, -1.9]). During the period analyzed, a decreasing trend in incidence was observed between 2011 and 2015, and an increasing trend for the period from 2015 to 2019. On the other hand, no change in the trend for mortality was found in Brazil.

Introduction: This study investigates physical and sexual violence against women in the municipality of Porto Nacional-TO between 2013 and 2022, addressing epidemiological aspects and social determinants involved. Violence against women, especially in domestic contexts and intimate relationships, is a human rights violation and a public health issue, the consequences of which widely affect society. The analysis of this violence in the region aims to provide relevant data for public policies that seek to reduce such occurrences. Methodology: This is an ecological epidemiological study, using data from the Notifiable Diseases Information System (SINAN) and obtained from DATASUS for all occurrences reported in Porto Nacional-TO. Cases of physical and sexual violence against females were included, and records with incomplete information were excluded. The analysis of incidence rates and trends was performed using the Stata®18 software, applying the Prais-Winsten method to estimate the annual percentage change and temporal trends of violence rates. Results: The analysis revealed a higher prevalence of physical violence in women aged 20 to 39 years and sexual violence in adolescents aged 10 to 19 years. Women who identified themselves as brown were the most affected in all forms of violence. Violence occurred predominantly in the domestic environment, and there was a significant increase in cases during the period of the COVID-19 pandemic, with a peak incidence of physical violence in 2020. The study also indicated that alcohol use was associated with a considerable portion of physical aggression. Discussion: The results confirm a growing trend of physical violence among young and adult women, highlighting the residence as the main place for these acts. Comparisons with other studies suggest that the characteristics observed in Porto Nacional are consistent with dynamics of violence found in other Brazilian regions, especially regarding the vulnerability of women in disadvantaged socioeconomic contexts. Conclusion: The high rates of physical and sexual violence, especially among young people and women of brown race, point to the need for public policies focused on prevention and care, especially in times of social crisis. It is essential to strengthen actions to monitor and combat gender violence to ensure greater safety and protection for women.

Retrospective Documentation of a Confirmed White-Lipped Green Pit Viper (Trimeresurus albolabris Gray, 1842) Bite in the South-Central Hills of Nepal

ABSTRACTObjective: The aim of this study was to analyze the trends in incidence, mortality, and lethality rates due to meningitis in children and teenagers aged 0-19 years in Brazil and its regions by sex from 2002 to 2022.Methods: This is a time-series study of the cases and deaths due to meningitis with data from the Notifiable Diseases Information System. We estimated the average annual percent change (AAPC) and its 95% confidence interval (95%CI) via Joinpoint regression, in addition to comparing the Brazilian Federative Units’ AAPCs by a pairwise coincidence test.Results: There were 274,500 cases and 17,162 deaths during the analyzed period, with downward trends both in Brazil and its regions regarding the incidence and mortality rates. In Brazil, the lowest AAPC in incidence was among males (AAPC=-5.7, 95%CI -7.1 to -4.2), whereas the lowest AAPC in mortality was among females (AAPC=-8.2, 95%CI -9.1 to -7.3). There were greater reductions in the incidence among males in all regions, except for the Central-West. Regarding the mortality rate, Northeast (AAPC=-9.6, 95%CI -10.6 to -8.5), South (AAPC=-8.1, 95%CI -9.8 to -6.3), and Central-West (AAPC=-8.5, 95%CI -10.7 to -6.3) showed their lowest AAPCs among females. There were significant differences in trends between males and females, mostly regarding incidence rates.Conclusion: Meningitis remains a concerning disease in Brazil, despite the downward trend in the country and its regions. It highlights the perpetuation of health inequalities, which reverberate in the levels of vaccination coverage and in the success of vaccination campaigns, impeding this disease’s proper control.

To characterise the geographic and spatiotemporal distribution of confirmed tuberculosis (TB) cases in Beijing between 2005 and 2009. The yearly notification rate maps were used to describe the distribution of confirmed adult TB patients. Spatial autocorrelation (Moran's I) and hot-spot analysis were adopted to detect the clusters and hot spots of TB. The TB incidence rate (cases per 100,000 population) in Beijing increased from 29.8 in 2005 to 35.0 in 2009. The incidence rate was significantly higher in the Urban Development New District and the Ecologic Reservation Development District (>30/100,000) than in the other districts. There was a significant spatial autocorrelation throughout the city (u = 2.58, P = 0.01). Evident clusters were observed in the Capital Functional Core District and the Urban Function Extension District (G(i)* > 1). Spatial autocorrelation and hot-spot analysis may serve as efficient tools to detect space-time clusters and geospatial hot spots of TB incidence. Between 2005 and 2009, TB incidence in Beijing showed population density and mobility-dependent and eco-social status-dependent space-time clusters and geospatial hot spots.

The objective of the current study was to estimate the self-reported individual-level crude prevalence and cluster-level adjusted prevalence of TB for the districts of Tamil Nadu and to understand the spatial distribution of TB cases through spatial autocorrelation and hotspot analysis. National Family Health Survey (NFHS) data, gathered during 2014-2015 (NFHS-4) and 2019-2021 (NFHS-5), were used in the current study to estimate district-wise, individual-level crude and cluster-level adjusted TB prevalence per 100 000 population in Tamil Nadu. This was illustrated with the help of spatial geographic representation for various districts of Tamil Nadu using SPSS and QGIS software. The spatial autocorrelation and hotspot analysis were performed using Geoda software. The overall self-reported individual-level crude prevalence of TB was 337 (95% CI 302 to 375) and 169 (95% CI 144 to 197) per 100 000 population, whereas the cluster-level adjusted prevalence of TB was 356 (95% CI 311 to 405) and 184 (95% CI 154 to 219) per 100 000 population in NFHS-4 and NFHS-5, respectively. This study highlights those geographical areas with high rates of TB prevalence. This information would be useful for the state and district programme managers to identify areas of high TB prevalence where interventions can be focused.

Snakebite envenoming is a neglected public health problem in many tropical countries, resulting in over 100 000 deaths and 400 000 disabilities worldwide each year. In Gabon, where venomous snakes are abundant, studies on the epidemiology and treatment of snakebites are lacking. Between October 2022 and June 2023, we conducted a cross-sectional community survey in the department of Ogooué et des Lacs in central Gabon to estimate the snakebite incidence, describe clinical presentations and treatment-seeking behaviours, and describe the burden of snakebites to animal populations in rural and urban communities. We also surveyed health facilities in the department to describe treatment practices and the availability of antivenom. The standardised annual incidence rate was 246 snakebite cases per 100 000 person-years (95% confidence interval (CI) = 138-438). Of the 175 snakebite cases reported in the five years prior to the survey, 18% showed signs of envenomation, predominantly with cytotoxic signs. The mortality among the bitten population was 3%. Snakebite treatment was first sought at a formal health facility in 55% of cases, from traditional healers in 22%, and with self-treatment or no treatment in the remaining 23%. Of snakebite patients treated at a formal health facility in the five years prior to the survey, 81% received antivenom, 41% received antibiotics, and 51% received corticosteroids. Almost one in six households reported animal deaths due to snakebites in the previous 12 months. This study provides the first robust epidemiological estimates of the burden of snakebites in Gabon and highlights the importance of community-based surveys in accurately assessing this high burden. Training health care workers, developing treatment guidelines, and ensuring the availability of effective and affordable antivenom are important steps to improving the outcome for snakebite victims.

BackgroundMonitoring trends in lung cancer incidence and mortality is important for the evaluation of cancer control activities. We investigated recent trends in age-standardized incidence rates by histological type of lung cancer in Osaka, Japan.MethodsCancer incidence data for 1975–2008 were obtained from the Osaka Cancer Registry. Lung cancer mortality data with population data in Osaka during 1975–2012 were obtained from vital statistics. We examined trends in age-standardized incidence and mortality rates for all histological types and age-standardized incidence rates by histological type and age group using a joinpoint regression model.ResultsThe age-standardized incidence rate of lung cancer levelled off or slightly increased from 1975–2008, with an annual percentage change of 0.3% (95% confidence interval [CI], 0.1%–0.4%) for males and 1.1% (95% CI, 0.9%–1.3%) for females, and the mortality rate decreased by 0.9% (95% CI, 1.2%–0.7%) for males and 0.5% (95% CI, 0.8%–0.3%) for females. The incidence rates of squamous cell carcinoma (SQC) and small cell carcinoma (SMC) significantly decreased for both genders, whereas that of adenocarcinoma (ADC) significantly increased among almost all age groups in both genders.ConclusionsThe incidence rates of SQC and SMC decreased with the decline in smoking prevalence, which probably explains the change in trends in the incidence rates of lung cancer from the mid-1980s. However, the reason for the increase in ADC remains unclear. Therefore, trends in incidence rates of lung cancer should be carefully monitored, especially for ADC, and the associations between ADC and its possible risk factors should be studied.

IntroductionSnake bites are a silent public health problem in Kenya. Previous studies on snake bites in the country have mainly focused on identifying offending snake species, assessing the severity of envenomation and testing the efficacy of antivenom. Factors associated with snake bites in the country are yet to be fully understood. The aim of this work was to determine pharmaco-epidemiological factors associated with snake bites in areas of Kenya where incidence, severity and species responsible for snake bites have been reported.MethodsKakamega provincial hospital, Kabarnet, Kapenguria and, Makueni district hospitals were selected as study sites based on previous findings on incidence, severity and species responsible for snake bites in catchment areas of these hospitals. Persistent newspaper reports of snake bites in these areas and distribution of snakes in Kenya were also considered. Cases of snake bites reported between 2007-2009 were retrospectively reviewed and data on incidence, age, site of the bites, time of bite and antivenom use was collected.Results176 bites were captured, 91 of which occurred in 2009. Individual incidence was between 2.7/100,000/year and 6.7/100,000/year. Bites peaked in the 1-15 year age group while 132/176 bites were in the lower limb area and 49/176 victims received antivenom. Most bites occurred during the dry season, in the bush and in the evening. Overall mortality was 2.27%.ConclusionThere is a need to sensitize the Kenyan public and healthcare personnel on preventive measures, first aid and treatment of snake bites.

Snakebite: Epidemiology, Prevention, Clinical Presentation and Management

Snakebite envenomation in the Brazilian Amazon: a descriptive study.

Introduction: Snakebite accidents are a public health problem and are considered clinical emergencies, what makes studies in high-incidence regions very important. Objective: To describe the clinical and epidemiological aspects of patients suffering from snakebite accidents in a region of the Western Amazon, Brazil. Methods: It is a cross-sectional, retrospective and documentary quantitative approach, from 2015 to 2016, held at the Regional Hospital of Juruá, located in the city of Cruzeiro do Sul, Acre, Brazil. Epidemiological data were obtained from the forms of the Notification Disease Information System (SINAN), in the Epidemiological Surveillance Sector of the hospital. The following variables were verified: month of occurrence, snake identification (type of accident), accident location (urban and rural), locality, municipality, victim data (age group, sex, anatomical region affected), symptoms and signs circumstances of the accident, time elapsed between accident and care, number of ampoules used, and type of serum. Results: An average of 124 cases of snakebite accidents were treated per year (76.71 cases per 100,000 inhabitants/year), most of them were botropic accidents and the patients were male adult and rural workers, bitten in the lower limbs. More than 30% of cases were treated six hours after poisoning and 24-hour care is a risk factor for complications, as seven of the eight patients who had complications were treated within one day of the accident. Conclusion: It was presented a constant increase in the cases, which generated a worrying point of reflection, which may be associated with two factors, where one turns to the improvement in the displacement of victims (improvements in branch roads and implementation of SAMU speedboat) facilitating plus transport and telephone coverage by improving communication, or the failure of public health policies to provide better conditions and guidance to the population.

ABSTRACTTwo patients from southern metropolitan Perth presented to Fremantle Hospital within a three week period with brown snake (genus Pseudonaja) envenomation, resulting in coagulopathy, thrombocytopaenia, anaemia and acute renal failure. Coagulopathy and thrombocytopaenia are well recognised complications of brown snake bite. However acute renal failure from brown snake bite has been described on only six previous occasions in the Australian literature, three from Western Australia in 1976. In these three cases, the genus of snake was not confirmed and the atypical envenomation syndromes suggested that other genera may have been responsible.In our patients, brown snake envenomation was confirmed with the Commonwealth Serum Laboratories Venom Detection Kit. The renal failure was self‐limiting in both cases though one patient required dialysis for 12 days. Neither patient developed rhabdomyolysis or myoglobinuria. These are the first cases of acute renal failure complicating definite brown snake envenomation reported from Western Australia. The most likely snake in both cases was the dugite (P affinis), however gwardar (P nuchalis) envenomation could not be excluded. Renal failure after brown snake bite is a rare but important complication.

Geographic trends in rare uterine sarcomas: could environment affect incidence? (403)

Snakebite by the Shore Pit Viper (Trimeresurus purpureomaculatus) Treated With Polyvalent Antivenom